Severe infection with encapsulated bacteria as the initial presentation of systemic lupus erythematosus: two case reports and a review of the literature.

Shaughnessy, Megan K.; Segal, Barbara

doi:10.1099/jmmcr.0.001362

Cited by 4 publications

(2 citation statements)

References 13 publications

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“…S. pneumoniae is the leading cause of pneumonia in SLE patients. In SLE patients, pneumococcal pneumonia is often severe, frequently acquiring a septicemic and fulminant course, occasionally described even at disease presentation [ 46 , 47 , 48 , 49 , 50 ]. For these reasons, a polyvalent pneumococcal vaccine is strongly recommended in SLE patients [ 51 ].…”

Section: Lung Infections In Systemic Rheumatic Diseasesmentioning

confidence: 99%

Lung Infections in Systemic Rheumatic Disease: Focus on Opportunistic Infections

Franco

Lucchino

Spaziante

et al. 2017

IJMS

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Systemic rheumatic diseases have significant morbidity and mortality, due in large part to concurrent infections. The lung has been reported among the most frequent sites of infection in patients with rheumatic disease, who are susceptible to developing pneumonia sustained both by common pathogens and by opportunistic microorganisms. Patients with rheumatic disease show a peculiar vulnerability to infectious complications. This is due in part to intrinsic disease-related immune dysregulation and in part to the immunosuppressive treatments. Several therapeutic agents have been associated to a wide spectrum of infections, complicating the management of rheumatic diseases. This review discusses the most frequent pulmonary infections encountered in rheumatic diseases, focusing on opportunistic agents, consequent diagnostic challenges and appropriate therapeutic strategies.

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Section: Lung Infections In Systemic Rheumatic Diseasesmentioning

confidence: 99%

Lung Infections in Systemic Rheumatic Disease: Focus on Opportunistic Infections

Franco

Lucchino

Spaziante

et al. 2017

IJMS

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“…It has been noted that clinicians should consider the possibility of complement deficiencies in adult patients with severe and unusual infection due to encapsulated organisms, and the presence of hypocomplementemia should suggest the possibility of SLE, even in patients with no prior history of SLE [ 8 ]. In this situation, treatment of both diseases should be performed simultaneously.…”

Section: Discussionmentioning

confidence: 99%

Sometimes There Is More Than One Puzzle on the Table: Pneumococcal Bacteremia as a New Systemic Lupus Erythematosus Presentation

Sheybani

Naderi

Mirfeizi

et al. 2015

Case Reports in Infectious Diseases

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Infection is common and a leading cause of death in patients with systemic lupus erythematosus (SLE). SLE is associated with a diverse spectrum of immune impairments including humoral defects and hypocomplementemia that contribute to a lupus patient's increased susceptibility to infection with encapsulated bacteria. Nonetheless, there are only few reports of severe invasive bacterial infection as the initial presentation of SLE in the literature. Here, we report a rare case of SLE presenting with pneumococcal bacteremia. Based on the high resolution chest computed tomography and the result of blood cultures, the bacteremia was assumed to be secondary to pneumococcal pneumonia.

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Individuality, phenotypic differentiation, dormancy and ‘persistence’ in culturable bacterial systems: commonalities shared by environmental, laboratory, and clinical microbiology

2015

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For bacteria, replication mainly involves growth by binary fission. However, in a very great many natural environments there are examples of phenotypically dormant, non-growing cells that do not replicate immediately and that are phenotypically 'nonculturable' on media that normally admit their growth. They thereby evade detection by conventional culture-based methods. Such dormant cells may also be observed in laboratory cultures and in clinical microbiology. They are usually more tolerant to stresses such as antibiotics, and in clinical microbiology they are typically referred to as 'persisters'. Bacterial cultures necessarily share a great deal of relatedness, and inclusive fitness theory implies that there are conceptual evolutionary advantages in trading a variation in growth rate against its mean, equivalent to hedging one's bets. There is much evidence that bacteria exploit this strategy widely. We here bring together data that show the commonality of these phenomena across environmental, laboratory and clinical microbiology. Considerable evidence, using methods similar to those common in environmental microbiology, now suggests that many supposedly non-communicable, chronic and inflammatory diseases are exacerbated (if not indeed largely caused) by the presence of dormant or persistent bacteria (the ability of whose components to cause inflammation is well known). This dormancy (and resuscitation therefrom) often reflects the extent of the availability of free iron. Together, these phenomena can provide a ready explanation for the continuing inflammation common to such chronic diseases and its correlation with iron dysregulation. This implies that measures designed to assess and to inhibit or remove such organisms (or their access to iron) might be of much therapeutic benefit.

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Severe infection with encapsulated bacteria as the initial presentation of systemic lupus erythematosus: two case reports and a review of the literature.

Cited by 4 publications

References 13 publications

Lung Infections in Systemic Rheumatic Disease: Focus on Opportunistic Infections

Lung Infections in Systemic Rheumatic Disease: Focus on Opportunistic Infections

Sometimes There Is More Than One Puzzle on the Table: Pneumococcal Bacteremia as a New Systemic Lupus Erythematosus Presentation

Individuality, phenotypic differentiation, dormancy and ‘persistence’ in culturable bacterial systems: commonalities shared by environmental, laboratory, and clinical microbiology

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